FNB Maternal and Fetal Medicine: Admissions, medical colleges, fees, eligibility criteria details

It focuses on managing the health concerns of the mother and fetus before, during, and shortly after pregnancy. Maternal–fetal medicine specialists are physicians who subspecialize within the field of obstetrics.

The course is a full-time course pursued at various accredited institutes/hospitals across the country, the top institutes include Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, Lok Nayak Jai Prakash (L N J P) Hospital and more.

Candidates can get admission to 2 years FNB course after successfully qualifying for the FET (Fellowship Entrance Test) examination which NBEMS conducts. FET is conducted annually as per the prescribed schedule. The merit-based counseling for admissions to the FNB Programme after the conduct of FET is administered by NBEMS.

The fee for pursuing FNB Maternal & Foetal Medicine varies from accredited institutes/hospital to hospital and is around Rs.1,25,000 per year.

After completion of their respective course, doctors can either join the job market. Candidates can take reputed jobs at positions as research fellows, Senior residents, Consultants, etc. with an approximate salary range of Rs.27 lakhs to Rs.59 lakhs per year.

The Nomenclature of the FNB qualification awarded by the National Board of Examinations in Medical Sciences is “Fellow of National Board”. The FNB qualifications are recognized qualifications in terms of the Gazette notification dated 10th August 2016.

What is FNB in Maternal & Foetal Medicine?

FNB in Maternal & Foetal Medicine is a two-year doctoral fellowship program that candidates can pursue after completing a postgraduate degree.

It focuses on managing the health concerns of the mother and fetus before, during, and shortly after pregnancy. Maternal-fetal medicine specialists are physicians who subspecialize within the field of obstetrics

The National Board of Examinations (NBE) has released a curriculum for FNB Maternal & Foetal Medicine.

The curriculum governs the education and training of FNB Maternal & Foetal Medicine.

Course Highlights

Here are some of the course highlights of FNB Maternal & Foetal Medicine

Name of Course	FNB Maternal & Foetal Medicine
Level	Fellowship
Duration of Course	Two years
Course Mode	Full Time
Minimum Academic Requirement	Candidates must have a postgraduate medical Degree in DNB/MD/MS Obst. & Gynaecology obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
Admission Process / Entrance Process / Entrance Modalities	Entrance Exam (FET)  Merit-based counseling administered by NBEMS.
Course Fees	Rs.1,25,000 per annum
Average Salary	Rs.27 lakhs to Rs.59 lakhs per annum

Eligibility Criteria

The eligibility criteria for FNB in Maternal & Foetal Medicine are defined as the set of rules or minimum prerequisites that aspirants must meet in order to be eligible for admission, which includes:

Name of Fellowship course	Course Type	Prior Eligibility Requirement
Maternal & Foetal Medicine	FNB	DNB/MD/MS Obst. & Gynaecology

Note:

The admission process contains a few steps to be followed for the candidates for admission to FNB. Candidates can view the complete admission process for FNB Maternal & Foetal Medicine mentioned below:

• FET is a qualifying-cum-ranking examination for admission to Fellow of National Board (FNB)/Fellow of National Board - Post Doctoral (FNB-PD) courses.
• The selection of a student will be through an MCQ-based examination namely Fellowship Entrance Test.
• A student can apply for the fellowship courses for which his/her broad or super specialty qualification/ equivalent qualification is eligible, at the time of online submission of the application form.
• The total duration of the question paper will be 105 minutes (Part A - 45 minutes and Part B - 60 minutes).
• QUALIFYING CRITERIA: Students who obtain a minimum of 50th Percentile in their respective question paper/specialty shall be declared as “Qualified”.
• NBEMS shall declare a specialty-wise merit list i.e., there will be a separate merit list for each fellowship course. There shall not be any equating/scaling and normalization. The merit shall be generated strictly based on marks obtained by the student and the application of the prescribed tie-breaking criteria.
• The admission to Fellowship courses in the accredited hospitals shall be undertaken solely based on merit-based counseling conducted by NBEMS.
• Documents required to be produced during counseling: MBBS Degree Certificate and MD/MS/DNB/DM/MCh/DrNB Degree Certificate/Provisional Pass Certificate of eligible Post Graduate Medical Qualification issued.

Fees Structure

The fee structure for FNB Maternal & Foetal Medicine varies from accredited institute/hospital to hospital. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for FNB Maternal & Foetal Medicine is Rs.1,25,000 per annum. 

Colleges offering FNB Maternal & Foetal Medicine 

Various accredited institutes/hospitals across India offer courses for pursuing FNB Maternal & Fetal Medicine.

As per the National Board of Examinations website, the following accredited institutes/hospitals are offering FNB Maternal and fetal medicine courses for the academic year 2022-23.

An FNB in Maternal & Foetal Medicine is a two years specialization course that provides training in the stream of Maternal & Foetal Medicine.

The course content for FNB Maternal & Foetal Medicine is given in the NBE Curriculum released by the National Board of Examinations, which can be assessed through the link mentioned below:

Syllabus:

The curriculum will be covered under the following modules. This is indicative and not limited only to follow the modules.

Skills for counseling the patient and her family, taking informed consent from the patient, and being available to answer questions, especially in an unexpected situation must be part of training for ALL modules. Counseling skills must include preconception care and counseling where required/ indicated.

Details of Modules:

Module 1: Maternal Medicine

Module 2: Antenatal Complications

Module 3: Intrapartum Care

Module 4: Postnatal care

Module 5: Foetal Medicine

Module 6: Genetics

Module 7: Neonatal Care: Medical & Surgical

Module 8: Miscellaneous

1. Module 1: Maternal Medicine:

The pathophysiology, presentation, and implications for maternal and/ or fetal health of

common maternal conditions present at booking or that may occur during pregnancy.

Effect of pregnancy on the medical conditions, the impact of treatment on mother and fetus.

Topics:

Detailed knowledge of the following:

i. Hypertension [HT]-chronic HT, preeclampsia, eclampsia, others

ii. renal disease-Chronic Kidney disease, Acute Renal Injury/ failure, Others

iii. Cardiac Disease - congenital heart disease [corrected, uncorrected], Rheumatic

Heart Disease [Operated, unoperated], Postpartum Cardiomyopathy.

iv. Hepatic Disorders, Obstetric Cholestasis, Acute fatty liver of pregnancy, Hepatitis, Pre-existing liver disease, and Others.

v. Gastrointestinal Disease-Pre-existing GI disease, Hyperemesis Gravid arum, Appendicitis, others

vi. Respiratory problems – Bronchial asthma, Influenza, etc.

vii. Neurology-seizure disorders, Migraine, ICSOL, CVA, Others

viii. Autoimmune/Connective Tissue Disease-SLE, APS, Others

ix. Hematological-Anemia, Haemoglobinopathies, Thrombocytopenia, Others

x. Thromboembolic Disease-Previous VTE, Thrombophilia [with and without previous VTE], Acute DVT, Pulmonary embolism, Others

xi. Psychiatric Disease- Postnatal depression, Puerperal psychosis, Maniac depressive disorders, Addictions

xii. Legal and Medico-legal issues, Others

xiii. Diabetes-Gestational diabetes mellitus, Type I DM, Type II DM, Others

xiv. Other Endocrinological Diseases-Thyroid disorders [Hypothyroidism,

Hyperthyroidism], Phaeochromocytoma

xv. Pregnancy after ART

xvi. Skin diseases in pregnancy

xvii. Substance Abuse-Smoking/ Tobacco/ Alcohol, Others

xviii. Neoplastic diseases -Before/ During pregnancy

xix. Infections –Tuberculosis, HIV, Hepatitis, Other Viral Infections, Urinary Tract

Infections, Pulmonary infections, Genital tract infections, vector-borne diseases

[Malaria, dengue], Covid and other new/ unusual infections, H1N1, etc.

xx. Acute Abdomen and other surgical problems during pregnancy – acute appendicitis, Cholecystitis, SAIO, etc.

xxi. Pregnancy after special surgery- post-transplant, Bariatric surgery, etc.

xxii. Domestic violence, mental health issues, etc.

xxiii. Vaccination in pregnancy

xxiv. Critical care obstetrics

Competencies / Skills

[Mandatory / Must Know]

i. Drugs/ Prescribing in Pregnancy

ii. Risk/ Severity Scoring of various types

iii. Patient Evaluation / Stabilization of the High-Risk Parturient

iv. Maternal and Foetal Surveillance in High-Risk Pregnancies

v. Planning and Conduct of delivery in these cases

vi. Fluid and Electrolyte management

vii. Near-miss morbidity and scoring systems for prediction

viii. Maternal death, Review, and audit

[Desirable / Good to know]

i. ABG Interpretation

ii. ECG Interpretation

iii. Chest X-Ray interpretation

iv. Insertion of CVP line

2. Module 2: Antenatal Complications:

Topics

i. Miscarriages / Foetal death - Recurrent early pregnancy losses [RPL], - diagnosis, investigations, and management. Intrauterine death, Ectopic pregnancy, Trophoblastic diseases, Cervical incompetence, Septic abortion, others

ii. Antepartum hemorrhage- Placental abruption, Placenta Previa, PAS disorders

iii. Preterm Birth-Prior history of preterm/PROM, Preterm labor, PROM [< 24, weeks,>24 Weeks], Elective preterm delivery, diagnosis, management, prediction, and prevention

iv. Multiple pregnancy - Complications, Single fetal demise, Co- twin demise after 12 weeks, Malpresentation, Delivery planning, Higher order multiple pregnancies.

v. Breech presentation at term/ other Malpresentation

vi. Postdate pregnancy

vii. Pregnancy with previous CS

viii. Polyhydramnios

ix. Abdominal/ Gynaecological Problems-Acute abdomen, Ovarian mass, Fibroid

uterus, Others

Competencies / Skills

i. Ultrasonography

[Mandatory / Must Know]

i. First-trimester scan: CRL, Chorion city, NT measurement, NB, and other gross

abnormalities

ii. Anomaly scan in detail

iii. Doppler Studies-Uterine, umbilical, Middle cerebral artery, Ductus venosus

Doppler,

iv. Screening for preterm birth – Measurement of cervical length

v. Growth scan and comparison with other standards

vi. Biophysical profile

vii. Ultrasound assessment of placental site (TVS)

viii. Morbid adherence to Placenta

ix. Cervical Cerclage – Elective

x. External Cephalic version

[Desirable / Good to know]

i. Doppler’s of other vessels

ii. Cervical Cerclage – Rescue, Abdominal

3. Module 3: Intrapartum Care

Topics

i. Normal labor and partogram (All types)

ii. Intrapartum foetal monitoring

iii. Failure to Progress-First stage of labor, Second stage of labor

iv. TOLAC

v. Multiple pregnancies

vi. Malpresentation- Breech labor and delivery, Transverse lie

vii. Shoulder Dystocia-Prior history of shoulder dystocia, Shoulder dystocia

viii. Instrumental delivery- Forceps/ vacuum

ix. Prevention and management of PPH- Massive PPH [with/Without

laparotomy], Balloon tamponade, UAE, DIC etc.

x. Genital tract Trauma-Prior history of 3rd/4th-degree perineal tear, Diagnosis

and repair of OASI, Uterine scar rupture, Others

xi. Cesarean Section, Cesarean hysterectomy, PAS disorders

xii. Anaesthesia/Analgesia- Assessment and Counselling high-risk case

xiii. Maternal Collapse-Massive hemorrhage, Amniotic fluid embolism,

Cerebrovascular accidents, septic shock

xiv. Assessment, transfer, and management of critically Ill women in HDU/ICU

Competencies and skills

[Mandatory / Must Know]

i. CTG interpretation

ii. Plotting and interpretation of partogram

iii. Digital Fetal scalp stimulation test

iv. Cesarean section- all types including repair of scar rupture

v. Versions-External cephalic

vi. Assisted vaginal delivery- Forceps/ vacuum/ breech/twin vaginal delivery

vii. Managing shoulder dystocia

viii. Repair of OASI

ix. Surgical management of PPH, genital trauma

x. massive transfusion protocols

xi. ICU management including fluid and electrolyte management, ABG interpretation

[Desirable / Good to know]

i. Vibroacoustic stimulation test

ii. Caesarean hysterectomy for PPH, PAS, etc.

iii. Use of different postures for birthing, Water birth

iv. Internal podalic version

v. ICU management - Intubation for mother and neonate, Knowledge of ventilator

settings etc.

vi. Labour analgesia techniques

vii. Cephalocentesis / craniotomy

4. Module 4: Postnatal care

Topics

i. Routine postnatal care

ii. Complications of puerperium

iii. Lactation – Physiology, Method, Problems, Solutions

iv. Contraception and Pregnancy termination– especially for high-risk cases

v. Postpartum depression

Competencies and skills

[Mandatory / Must Know]

i. Ideal position for breastfeeding

ii. Clinical Diagnosis and Management of common complications

iii. Contraceptive counseling pertinent to a case

5. Module 5: Foetal Medicine

Topics

i. Embryology – normal and development of fetal abnormalities

ii. Normal fetal behavior and activity and its abnormalities

iii. Foetal circulation and adaptation at birth

iv. Management of pregnancies complicated by fetal abnormalities of various organ

systems

v. Offer prenatal tests, liaise with the multidisciplinary team for the care, make a management plan, and counsel about pregnancy and long-term outcomes. Make a

genetic referral and its justification.

vi. PCPNDT Act

vii. Occurrence, Diagnosis, Management, Prognostication, etc. of Anomalies listed

a. CNS Anomalies-Anencephaly, Spina bifida, Ventriculomegaly, Dandy walker

malformations/variant, Holoprosencephaly, Others

b. Cardiac: ASD, VSD, Hypoplastic right and left heart, TOF, etc Anomalies of

various chambers, Outflow tract abnormalities, Arrhythmias, and Others

c. Renal Anomalies-Renal agenesis, Hydronephrosis, Polycystic Kidney

(AR/AD), Megacystis/LUTO, Others

d. Pulmonary abnormalities-CCAM, Diaphragmatic hernia, Others

e. Face & Neck Anomalies-Cystic hygroma, Facial cleft, Others

f. Abdominal wall & gastrointestinal anomalies-Gastroschisis, Exomphalos,

Others

g. Skeletal anomalies-Talipes, Skeletal dysplasia, Others

viii. Assessment of fetal growth & growth abnormalities

ix. Pregnancy complicated by red cell allo- immunization – diagnosis of fetal anemia, interpretation of MCA Doppler, IUT, Delivery

x. Hydrops – Nonimmune: Causes, investigations, management, counseling, plan for pregnancy management

xi. Multiple pregnancies- Establishing chorion city, Antenatal and Intrapartum care, Growth problems in twins. Complications of monochromic twins – TTTS, sFGR,

TAPS and TRAP – diagnosis, follow-up, and management

xii. Foetal Infections-TORCH, Parvovirus, others – Interpret lab tests, Explain fetal and

new-born effects on infection, prenatal diagnosis, and management

xiii. Liquor Abnormalities-Oligo / Polyhydramnios

xiv. Prenatal fetal therapy

Competencies & Skills

[Mandatory / Must Know]

h. Multifetal pregnancy- Detect, and monitor a twin pregnancy, Manage pregnancy with

growth problems

iii. Care for women with red cell all immunization – Monitoring for fetal anemia,

Intrauterine transfusion, Delivery, Postnatal Management etc.

iv. USG for normal fetal anatomy and diagnosis of fetal anomalies of fetal CNS, Face, Neck, Thorax, CVS, abdominal wall and GIT, UGT, Foetal skeleton, and extremities [TIFFA]

v. Able to use USG in pregnancy – optimize image, appropriate Doppler

vi. USG for fetal growth, recognize and manage early and late-onset FGR

vii. Counselling for prenatal invasive procedures, Prerequisites, Procedures, Post procedure care and follow up

a. Amniocentesis below:

b. Chorion villus sampling

c. Cordocentesis

viii. Diagnose abnormalities of liquor, Amnioreduction

ix. Counselling for termination of pregnancy for fetal anomalies

x. Prognostication of the anomalous fetus

xi. Communication skills- Breaking bad news

xii. Preconception counseling for cases whose last pregnancy was affected by any of above

xiii. Counselling for Neonatal Surgery-Abdominal wall defect, Diaphragmatic hernia, Bowel atresia, Spina bifida, others

xiv. Workup of previous/ unexplained stillbirth

xv. Coordination with Paediatric Physician/ Surgeon for postnatal management

[Desirable / Good to know]

i. Monochorionic twins: TTTS, sFGR, TRAP – Diagnosis, Management, Prognosis

etc.

ii. Exchange transfusion

iii. Advanced USG – Foetal Echocardiography, Neuroanatomy, etc. as per ISUOG guidelines

iv. Selective fetal reduction in dichorionic twins and Vaso occlusive techniques in MC

twins

v. Fetal pathology and Fetal autopsy

vi. Fetal red cell intravascular/ intraperitoneal transfusion

6. Module 6: Genetics

Topics

j. Normal chromosome structure and function. Gene structure and function

i. Patterns of genetic inheritance and susceptibility

ii. Types of aneuploidy, including structural rearrangements, Deletions,

Trisomy, Sex-chromosome abnormality, etc.

iii. Genetic etiology of single gene disorders, concerning common disorders:

Hemoglobinopathies and Bleeding disorders, Inborn errors of metabolism,

Muscular dystrophy

iv. Knowledge of common syndromes and associations: e.g. Meckel-Gruber,

Beckwith-Wiedmann, DiGeorge etc.

v. Pre and postnatal phenotypes of common aneuploidies, Single gene disorders,

Syndromes

vi. Methods of screening for aneuploidy include – USG, biochemical, and non-invasive.

vii. Understand terms relevant to screening, Sensitivity, Specificity, False positive,

False negative, LR.

viii. Invasive tests – amniocentesis, CVS, FBS

ix. Molecular basis and Laboratory techniques for analyzing parental and fetal

samples, including PCR, FISH, Karyotyping, microarray, Mutational analysis,

Next Generation Sequencing (NGS)

x. Chromosomal Anomalies-Previous history/family history/ affected fetus

xi. Genetic anomalies - Previous/family history/current pregnancy

xii. Syndromic anomalies - Previous/family history/current pregnancy

xiii. Index child workup

xiv. Modes of Inheritance

xv. Preimplantation Genetic Diagnosis [PGD]

Competencies & Skills

[Mandatory / Must Know]

i. Ultrasound screen for aneuploidy 11-13+6 weeks’ scan – measurement of CRL, NT, NB, DV, TR, identification of gross structural anomaly

ii. Genetic counseling – Pedigree charting

iii. Interpretation of screening tests and further management of abnormal test

iv. Pregnancy at risk / affected by aneuploidy – take a history, arrange parental and prenatal investigations, counsel regarding risk, screening, and testing options, and genetic consultation if needed.

v. Pregnancy at risk / affected by single gene disorder – take a history, make family

tree, Parental investigations, communication risk, Screening, and testing options,

Referral for genetic consultation.

vi. Diagnosis and management of genetic and syndromic disorders

vii. Biochemical screening, molecular, and cytogenetic tests for prenatal diagnostic

investigations- interpretation and communication of test results and appropriate

multidisciplinary consultation.

viii. Foetal autopsy – Counselling, Indications, Technique

[Desirable / Good to know]

i. Lab knowledge of molecular testing

ii. Conducting / Performing a fetal autopsy

9. Module 7: Neonatal Care: Medical & Surgical

Topics

i. Characteristics of a healthy neonate

ii. Neonatal resuscitation

iii. Birth asphyxia

iv. Meconium aspiration syndrome

v. Birth trauma

vi. Small for gestational age

vii. Neonatal jaundice

viii. Assessment of New-born

a. New-born resuscitation

b. New-born screening

c. New-born with gross congenital anomaly

d. Evaluation and Management of Antenatally diagnosed structural anomaly

e. Birth trauma

f. Cord Blood ABG

g. Others

Competencies & Skills

[Mandatory / Must Know]

i. Essential care of New-born including resuscitation

ii. Palade feeding

iii. Kangaroo mother care

iv. Gestational age assessment postnatally (Ballard scoring)

v. Growth evaluation- Ponderal index etc.

[Desirable / Good to know]

i. Sick new-born care

ii. Cord and IV cannulation

8. Module 8: Miscellaneous

Topics

i. Dietary recommendation in pregnancy

ii. Modification of diet in special conditions e.g., diabetes in pregnancy

iii. Exercise in normal pregnancy

iv. Modifications of Exercise routine and dietary counseling for special cases e.g.

Hypertension, Obesity, Renal, and Hepatic disorders

v. non-conventional methods of pain relief in labor- Hypnotherapy, Meditation,

Yoga and other traditional methods

Career Options

After completing FNB Maternal & Foetal Medicine, candidates will get employment opportunities in Government and the Private sector.

In the Government sector, candidates have various options to choose from which include Junior research fellow, Teaching at academic medical centers, and Consultants.

While in the Private sector, the options are Fellow (Maternal and Fetal Medicine), Junior research fellow (Maternal and Fetal Medicine), Senior Research fellow (Maternal and Fetal Medicine), and Consultants (Maternal and Fetal Medicine).

Frequently Asked Questions (FAQs) –FNB Maternal & Foetal Medicine Course

• Question: What is the complete form of FNB?

Answer: The full form of FNB is Fellow of National board.

• Question: What is an FNB Maternal & Foetal Medicine?

Answer: FNB in Maternal & Foetal Medicine or Fellow of National Board in Maternal & Foetal Medicine is a doctoral fellowship program for doctors in India that is done by them after completion of their postgraduate medical degree course.

• Question: What is the duration of an FNB in Maternal & Foetal Medicine?

Answer: FNB in Maternal & Foetal Medicine is a doctoral fellowship program of two years.

• Question: What is the eligibility of an FNB in Maternal & Foetal Medicine?

Answer: Candidates must have a postgraduate medical Degree in DNB/MD/MS Obst. & Gynaecology obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.

• Question: What is the scope of FNB Maternal & Foetal Medicine?

Answer: FNB Maternal & Foetal Medicine offers candidates various employment opportunities and career prospects.

• Question: What is the average salary for an FNB Maternal & Foetal Medicine candidate?

Answer: The FNB Maternal & Foetal Medicine candidate’s average salary is between Rs.27 lakhs to Rs.59 lakhs per year depending on the experience.

• Question: Can you teach after completing FNB Maternal & Foetal Medicine Course?

Answer: Yes, the candidate can teach in a medical college/hospital after completing the fellowship.